[Summary] Good glycemic control can delay the occurrence and development of diabetic complications. Artificial pancreas, which autonomously mimics the physiologic glucose control of pancreas islet, regulates the blood glucose subtly. Artificial pancreas seems to be one of the promising glucose control approaches.

Left atrial appendage ( LAA) arises from the left atrial free wall. It is the remnant of the original embryonic LA, distinct from the rest of the left atrium. It has a unique anatomical structure, physiological function, hemodynamic characteristics. LAA has complex surrounding structures, great variability, and close relation with thrombosis. This paper reviews the morphological and functional characteristics of LAA. Familiar with adjacent relationship of LAA and correlation between LAA and thrombus formation has important clinical significance that can reduce the risk of postoperative complications in interventional procedures, the incidence of car?dioembolic stroke, the clinical misdiagnosis on LAA thrombosis.

Objective To discuss the expression and the related factors of E-selectin in insulin-resistant(IR)rat endothelium. Methods Wistar rats were randomly divided into 3 groups: high fat feed,high fructose feed and the control feed(HF group,HG group and NC group). IR rat model was established by high fat feeding or high fructose feeding for 4 weeks and was evaluated with euglycemic clamp technique. E-selectin protein expression was detected by Western-blot analysis. Results The expression of E-selectin protein in vessel endothelium was increased in HF group and HG group compared with that in NC group (P<0.01), and higher in HF group than in HG group (P<0.05). E-selectin protein expression was correlated significantly with TG, FFA, FIns and HOMA-IR in HF group and HG group (P<0.05). Conclusions IR may cause the increased expression of E-selectin in endothelium of rats fed with high fat or fructose.

Objective To explore the clinical and MRI features of spontaneous osteonecrosis of the knee(SONK).Methods 15 patients with SONK diagnosed by clinic and imaging were collected.All of cases were examined by MRI,of them 5 cases underwent CT scan and 3 cases underwent radiographic examinations.Results The subchondral lesions were seen in all cases on MRI and the lesions located in the femoral condyle weight-bearing zone in 14 cases.The subchondral "fracture cleft"sign was found in 2 cases;the subchondral long T1 and short T2 linear abnormal signal intensity surrounding with bone marrow edema were shown by MRI in 3 cases of them.The subchondral focal lesions were slight long T1 and long T2 signal intensity in 10 cases.The subchondral lesion were showed clearly only in 2 cases of 5 cases with CT scan,and only 1 case of 3 cases with plain X-ray examinations.Conclusion MRI is more sensitive than CT and radiography in showing the lesions of SONK.The SONK can be diagnosed based on the clinical and MRI features.

AIM: Our study focused on investigation of tissue specific regulatory activity of the newly cloned promoter: PLUNC-p with driving enhanced green fluorescent protein ( EGFP ). METHODS: Transgenic Xenopus Laevis system was applied.RESULTS: The green fluorescence protein directed under PLUNC-p was expressed strictly in branchial arches and epidermis of Xenopus Laevis embryos while CMV promoter showed ubiquitous regulation characteristic.CONCLUSION: PLUNC-p is able to direct epithelia specific expression of EGFP . This property of PLUNC-p might raise the possibility that lead target genes to express tissue-specifically.

Objective To investigate the effects of N - acetylcysteine (NAC) on apoptosis and the expressions of Fas/FasL mRNA in lung tissue of rats with paraquat - induced acute lung injury.Methods Forty five male SD rats were randomly (random number) divided into normal control group,paraquat (PQ) group,and NAC treatment group.The rat model of acute lung injury was made with 2％ PQ induction in dose of 25 mg/kg injected,and NAC was injected into the PQ poisoning rats (200 mg/kg) 30 minutes after PQ administration in NAC treatment group.In the control group,equal amount of saline instead was injected into the rats.Apoptosis was detected by using TUNEL method and the expressions of Fas/FasL mRNA were evaluated by using reverse transcription polymerase chain reaction (RT- PCR),and the levels of Fas/FasL protein were detected by using western blot analysis.Results Compared with control group,cell apoptosis and expressions Fas/FasL mRNA in PQ group were significantly different ( P ＜ 0.05 ).Compared with PQ group,cell apoptosis and expressions Fas/FasL mRNA in NAC group were significantly decreased,were significant lower (P ＜ 0.05).Conclusions NAC inhibited apoptosis in lung tissue of rats with paraquat induction by regulating the activation of Fas/FasL systems.

Objective To determine the diagnostic value of the change of different parts of electrocardiogram in treadmill exercise test (TET) for coronary heart disease (CHD).MethodsFrom Jan.2006 to Mar.2011,445 patients with CHD underwent treadmill exercise test and coronary angiography (CAG) in our hospital.We analyzed retrospectively the diagnostic value of the change of different parts of electrocardiogram in TET test.Results ( 1 ) There were 200 cases who had positive results during treadmill exercise test and 150 cases of them had been diagnosed of CHD by coronary angiography;The other 245 cases had negative results during treadmill exercise test and 39 cases of them had been diagnosed as CHD by coronary angiography.The sensitivity and specificity rates of treadmill exercise test in diagnosis of CHD were 79.36％( 150/189 ) and 80.47％ ( 206/256 ) respectively. ( 2 ) Of the 200 positive cases tested by coronary angiography,150 cases were diagnosed of CHD,including 22,58 and 70 cases with limb,chest and combined chest and limb leads positive results respectively.The positive rates for the groups of combined chest and limb leads and limb ST leads were significantly higher than that of the chest leads only group ( x2:6.34,3.93 ; P ＜0.05).(3)R wave amplitude of the CAG negative group after exercise (17.54 ± 2.52)mm was significantly lower than the CAG positive group ( 19.42 ± 3.46 )mm ( t =6.33,P ＜ 0.05 ).( 4 ) For the 200 cases with positive TET,there were no significant statistical difference ( P ＞ 0.05 ) on CAG positive rate between T wave normalization group [ 73.3％ (44/60) ] with and TET positive group [ 75.0％ (105/140) ].But these two groups had significantly higher ( x2:80.21,132.82 ; P ＜ 0.05 ) CAG positive rates than TET negative group [ 15.9％ (39/245) ].ConclusionThe treadmill exercise test is valuable in noninvasive diagnosis of CHD.The severity of CAG can be preliminarily estimated by analyzing the pattern of the change of different parts of electrocardiogram

Objective To evaluate clinical significance of the grade of ischemia by QRS complex on the admission electrocardiogram(ECG)to predict severe arrithmia in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods Patients with acute ST-segment elevation myocardial infarction(STEMI)admitted to emergency department from July 2003 to April 2008 were enrolled.A total of 223 patients met the criteria(ischemic chest pain ≥ 30 min,2 or more adjacent leads of ST segment elevation and onset time within 12 h).Exclusion criteria were bundle branch block and left ventricular hypertrophy.All enrolled patients were divided into two groups based on the enrollment electrocardiogram:grade 2 ischemia(ST elevation without terminal QRS distortion; n =134)and grade 3 ischemia(ST elevation with terminal QRS distortion; n =89).Patients of the two groups had comparable genderproportion,average age and coronary heart disease risk factors etc.All patients received thrombolytic therapy.The incidence rate of ST segment resolution(STR)and severe arrithmia in hospital stay were observed.Numerical variables were expressed mean ± standard deviation and compared by unpaired Student't test,Categorical variables were expressed percentage and compared by chi square test.Multiple logistic regression analysis was used to determine independent predictors of severe arrithmia.Results Patients with grade 3 ischemia had greater Σ ST on admission and 2 h after thrombolysis ECGs(P ＜ 0.01),the incidence rate of STR in patients with grade 3 ischemia was lower than that in patients with grade 2 ischemia(P ＜0.01).The peak creatine kinase MB fraction was higher in patients with grade 3 ischemia than that in patients with grade 2 ischemia(P ＜ 0.01).There was no significant difference of the incidence of severe arrithmia,such as ventricular premature beat,ventricular tachycardia or fibrillation,second-degree or third-degree atrioventricular block,and sinus arrest between the two groups(P ＞ 0.05),but there was a trend of higher incidence of severe arrithmia in patients with grade 3 ischemia compared with that in patients with grade 2 ischemia.Multiple logistic regression analysis demonstrated that the independent predictors of severe arrithmia were duration from symptom to thrombolysis and initial.Σ ST,whereas grade 3 ischemia remained a strong predictor of severe arrithmia.Conclusions Grade 3 ischemia on admission is associated with lower incidence of STR in patients with ST-segment elevation myocardial infarction(STEMI)after thrombolysis and a strong predictor of severe arrithmia.

Objective To study the impairment and the expression of receptor of advanced glycation endproduct (RAGE) in cultured rat glomerular mesangial cells ( GMC ) induced by constant and intermittent high glucose, and to investigate the pathogenesis of diabetic nephropathy. Methods After being cultured under constant and intermittent high glucose with different concentrations for 24 and 48 hours, the morphological changes of rat mesangial cells were observed, the proliferation of GMC was detected by MTT assay, the activity of superoxide dismutase (SOD)and the level of malondialdehyde (MDA)in supernatant were measured by spectrophotometer,and the expressions of RAGE mRNA were evaluated by RT-PCR. Results ( 1 ) Compared with the control group,the cellular morphology was changed in case of constant and intermittent high glucose. The damage of GMC with intermittent high glucose concentrations was more serious. (2)The activity of SOD was decreased and the level of MDA was raised in case of intermittent high glucose concentrations compared with the constant high glucose concentrations (P＜0.05). (3)The expression of RAGE mRNA with intermittent high glucose concentrations was significantly higher than that with constant high glucose concentrations ( P＜0. 01 ). Conclusions The damaging effects and increased expression of RAGE in cultured rat GMC induced by blood glucose fluctuation was much worse than that with constant high glucose. The blood glucose fluctuation may be one of the causes that induce diabetic nephropathy.

Objective To determine the characteristics of paresteal lipomas with hypemstosis (esteochondromas or osseous protuberances)on CT images and to improve the knowledge of diagnosis and differential diagnosis of the disease.Methods CT images and clinical history of 6 patients with pathologically confirmed parosteal lipemas with hyperostosis were retrospectively reviewed.All of the 6 patients underwent plain CT scans.Results CT images clearly show lipomas and osseous projections or osteochondroma in the 6 cases.Parosteal lipomas were found with osteochondronms in 2 cages(1 at the isehium.and the other 1 at the femoral trochanter)and willl osseous protuberances in 4 cases(2 at the diaphysis offemurs.1 at the diaphysis oftibia and the other 1 at the sternum).These osteochondromas and ossous protuberances were surrounded by the adipose component of the neoplasm and had a firm attachment oftlle neoplasm to the underlying bone.The size ofthe osseous projections varied from 0.3 cm x1.2 cm to 6.0 cm x 4.0 cm.The shape of the osgeous projections was various.Osteochondromas found in 2 cases showed cortical continuity with the adjacent bone together with marrow continuity with tlle adjacent bone marrow.In the 4 cages of parosteal lipama with osseous protuberances,2 to 4 osseous protuberances were found in 2 case8 and solitary osseous protuberance were found in the other 2 cases.The lipomatoas companent showed typical features of adipose tissue on all images.The size of the lipomas varied from 3.0 cm ×2.0 cm to 11.0 cm×10.0 cm with clear border.Fibrous septa of different thickness were found within the adipose tissue.There was essification and (or) calcification in 1 case and muscle atrophy in 2 espies.Conclusions CT scan is useful in the presurgical evaluation of parosteal lipomas witll osteochondromas or osseous protuberances became it can demonstrates the morphology,location and extent of the lesions.and it can show their relationship to the surrounding structures. It is important for differential diagnosis and preoperative assessment of the lesion.